Effect of COVID-19 infection during pregnancy on Cerebro-placental circulation (Prospective study)

Abstract

Background: Most pregnant women who are positive for SARS-COV-2 are asymptomatic and have a low prevalence of perinatal complications. Initially, there was an overreaction concerning the potential complications of SARS-COV-2 in pregnancy, with an increase in rate of indicated preterm birth in order to avoid foetal exposure to the virus. However, now that clinical experience has accumulated, the general consensus is that only minimal or mild foetal side effects are associated with maternal SARS-COV-2 infection during pregnancy. Aim of the work: The aim of the study is to evaluate the effect of the infection with SARS- COV-2 early in pregnancy on cerebroplacental circulation. Methods: This prospective study was conducted at tertiary care hospital at ultrasound and foetal medicine unit, Ain Shams University Maternity Hospital from January 2021 till June 2023 and performed on total 283 pregnant women who had infected with SARS-COV-2 during early pregnancy (first trimester or early second trimester), compared to 283 healthy pregnant women as a control group with inclusion and exclusion criteria. Results: There were no statistically significant differences between the studied groups regarding Middle cerebral artery (MCA) pulsatility index (PI). There were no statistically significant differences between the studied groups regarding Middle cerebral artery (MCA) resistive index (RI). There were no statistically significant differences between the studied groups regarding Umbilical artery (UA) pulsatility index (PI). There were no statistically significant differences between the studied groups regarding Umbilical artery (UA) resistive index (RI). There were no statistically significant differences between the studied groups regarding cerebroplacental ratio. Conclusion: As evident from the current study, this present study reported no significant differences in fetomaternal blood flow parameters in pregnant women who had infected with SARS-COV-2 infection during early pregnancy (first trimester or early second trimester) compared to those who have not had the disease using doppler parameters of umbilical artery, middle cerebral artery and cerebroplacental ratio. In our opinion, the findings of this specific study may improve our limited knowledge for the application of Doppler ultrasound in pregnant women with COVID-19.